Ensuring HIPAA Compliance in Healthcare Apps with Startup House: A Comprehensive Guide

Marek Majdak
11 May 2023
3 min read

At Startup House, we pride ourselves on building HIPAA-compliant apps that adhere to the highest security standards. Our dedicated DevOps team supports, monitors, upgrades, and maintains infrastructure and deployment processes while ensuring compliance with HIPAA guidelines to protect electronic Protected Health Information (ePHI). In this blog, we will provide a detailed outline of the comprehensive measures we take to ensure a secure and compliant environment for your healthcare app.


Advanced Cloud Solutions for Privacy, Security, and Notification:


We utilize advanced cloud solutions to meet all HIPAA requirements, including:

  • Executing a Business Associate Agreement (BAA) with the cloud provider

  • Network security measures, such as dedicated VPCs and private clusters

  • Firewall rules and encrypted traffic


By leveraging advanced cloud solutions, we meet all the requirements set by HIPAA, ensuring your healthcare app remains secure and compliant. Our team works diligently to maintain high levels of privacy, security, and notification in accordance with HIPAA guidelines.


Comprehensive Audit Logs for Simplified Compliance:


Our auditing process includes:

  • Kubernetes audit policies

  • Database audit logs (pgaudit extension)

  • VPN connection logs

  • Ingress gateway request logs

  • Loki tool for log aggregation

  • Configurable log retention periods, stored for many years


Our comprehensive audit logs simplify the compliance process and make it easy to comply with external audit requests. By offering a complete record of actions and configurable retention periods, we go beyond HIPAA's minimum requirements, providing you with peace of mind.


Robust Security Measures for Peace of Mind:


We implement multiple levels of protection, including:

  • Physical security: Execute a BAA with the cloud provider

  • Network security:

    • Dedicated VPC for private cluster and database

    • Private cluster; connection to Kubernetes API only from private network or VPN

    • Private nodes enabled

    • Internet access from the cluster only through dedicated Cloud NAT

    • Firewall (Istio gateway as WAF)

    • VPC firewall rules

    • Network security inside the cluster

    • Traffic encryption (mTLS for the whole Istio mesh)

    • Network Policies for API services

    • Enforcement of HTTPS for all requests to the API

    • Regular penetration tests and Kubernetes configuration scans (kube-hunter and kube-bench)

  • Access Management:

    • Database access with IAM accounts

    • Kubernetes RBAC with Rancher

    • Rancher access with IAM accounts

    • 2FA authentication


Our robust security measures ensure that your app is well-protected at all times. With multiple layers of security, we create a highly secure environment that complies with HIPAA standards and offers peace of mind to our clients.


24/7 Threat Detection and Automatic Penetration Testing:


We ensure continuous monitoring and proactive identification of vulnerabilities using:

  • Falco threat detection system

  • On-request external penetration tests

  • Automated penetration test tools (kube-hunter)

  • Internal scanning systems (Terrascan, kube-bench)


We prioritize continuous monitoring and proactive identification of vulnerabilities to maintain a secure environment. Our 24/7 threat detection and automatic penetration testing tools ensure that your healthcare app remains safe and secure, giving you the confidence to focus on your core business.


Secure Data Storage with Cloud SQL:


Our secure data storage solutions include:

  • Encryption at rest and in transit

  • Private IP for SQL instances

  • Dedicated DB users

  • Automated backups with point-in-time recovery

  • Developer access secured via VPN

  • Instance replication in multiple zones


Our secure data storage solutions utilize Cloud SQL, Cloud native database from AWS or Azure to ensure the highest level of protection for your app's data. With encryption at rest and in transit, private IP addresses, and automated backups, your healthcare app's data remains secure and accessible when needed.


Domain Security and High Availability for Your App:


We offer domain security measures such as:

  • Proxied application domain DNS entries

  • Full encryption (enforce TLS between Cloudflare servers and application)

  • Minimum TLS version set to 1.2

  • Additional WAF rules from Cloudflare Managed Ruleset and OWASP check

  • DDOS and flood protection

  • Bot protection


We prioritize domain security and high availability for your healthcare app to keep your online presence safe from threats. By implementing domain security measures such as proxied application domain DNS entries, full encryption, and additional WAF rules, we ensure a robust defense against potential attacks. Additionally, our high availability solutions, including regional clusters and automated cluster backups, guarantee the continuous operation of your app.


We also provide high availability with:

  • Regional clusters (replicated in multiple zones)

  • Dedicated nodes for application pods

  • Automated backups of the whole cluster (Velero)


Startup House is your trusted partner for building HIPAA-compliant healthcare apps that meet the highest security standards. Our comprehensive security measures and affordable monthly cost and maintenance fee make it easy to invest in your app's ongoing security and compliance. Choose Startup House for a reliable and secure solution that gives you peace of mind.

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